1. Do you use a special no scar
technique for Labiaplasty? Some surgeons will just remove the excess tissue
and the scars will run down the length of the labia. Will this leave unnatural
scarring? Will it be obvious?

The so-called “scar-less” technique is an absolute
fallacy. In this widely talked about technique, what's typically performed
is that an inverted triangle is cut on the backside of the labia, roughly
in the middle, and the tissue is then retracted, or pulled back, to make
the labia smaller. This is usually a twenty-minute procedure and it is
called “scar-less” because no one typically is going to see
the inside, hidden areas of the labia.

In surgery, when a doctor wants to make something tighter,
it's common knowledge that the area is opened horizontally . . . and then
closed vertically. In this method of labiaplasty, the point of the triangle
cut is near the widest part of the labia—then the tissue is pulled
in. The problem with this technique is that it fails to address the three
most important issues, or complaints facing patients seeking labiaplasty.
They are; 1) dark tissue pigmentation (dark color of the tissue in the
problematic area); 2) the thickness of the tissue in the labia, and; 3)
the “rugated” (ruffled), uneven edges of the labia. Unfortunately,
this technique allows for simply drawing inward the tissue in question,
leaving it still visibly (anatomically) present after the surgery. Usually
the patient ends up with smaller labia—but with the same dark, thick,
ruffled tissue— now amassed in a concentrated area, often making
the results appear worse than before.

2. Is it recommended to undertake
this type of surgery if I've not had children yet?

Absolutely. If large labia bother you either physically,
or emotionally . . . then it simply doesn't make any sense to live with
these physical or emotional pains. Why would you wait? After labiaplasty,
your self-esteem and anatomical form will be corrected.

The surgery can be done with local anesthesia, level two
IV sedation, or level three general anesthesia's (anesthesia). Most surgeons
prefer IV sedation, or what is commonly known as “twilight sleep”,
as it makes postoperative recovery immediate and usually results in none
of the discomfort from general anesthesia—typically, post op drowsiness,
nausea, vomiting and endotrachial post-surgical effects.

Over 90% of cases are from outside the region. Our skilled
staff can help facilitate ease of travel and planning. In recognizing
the difficulty of travel today, due to increased security, only one trip
is ever required. Patients may come in for a post-op exam if they wish,
and are encouraged to do so (4-6 weeks after surgery), but it’s
not always possible when traveling from out of the area. In those instances,
some patients can simply send a photograph of the surgical area for the
doctor’s review post-operatively. All routine pre-op tests and blood
work are performed by 4PM the day before surgery.

5. Is it better to have labiaplasty
done at an early age if there is a need, or is it better to wait until
one gets older?

In almost every case, it’s better to have labiaplasty
done when it’s needed. If large labia bother you either physically,
or emotionally . . . then it simply doesn't make any sense to live with
these physical or emotional pains.

Only five years ago, few patients knew of labiaplasty surgery
to correct problematic areas. Today, with a heightened awareness of the
problem by both young girls and parents, many are now turning to the surgical
methods available to correct these problems. The reasons are that young
women today are more physically active and armed with the knowledge that
there is a simple, one-hour surgery to correct the problem—thus
many women are moving forward with labiaplasty while still young. As far
as any medical reason for delaying a labiaplasty, there simply isn't one.
Whether or not a young woman decides to have the minimal procedure performed,
or not, is up to how she feels about herself. In those cases, women and
young girls who have an actual physical problem with their labia—such
as large, or asymmetric labia—having labiaplasty performed early
can result in an anatomical correction that results in greater patient
self-esteem as they mature.

7. Will my sexual partner see
or feel any changes resulting from my labiaplasty?

Feeling a change after a labiaplasty largely depends on
the degree of labia abnormality to begin with. Simply said, if there is
enough labia tissue present before a labiaplasty is performed that interferes
with sexual activity, then usually the sexual partner will feel a difference
after labiaplasty, because the excess tissue won’t interfere with
any sexual act as it might have before.

As well, it will be very apparent to your sexual partner
that the external structure of the labia will have been altered visually—namely,
they’ll be smaller and better aligned. Your sexual partner will
clearly notice this change for the better.

There is no physiological association for sensory pleasure
with the labia—that function is served by the clitoris. The only
sensation elicited from labia is pain upon tearing or stretching. Labiaplasty
can’t cause a loss of sensitivity when done correctly.

In most instances, no. However, in those cases where women
have excessively large labia, the skin around the clitoris is reduced
due to the retraction of tissue during the labiaplasty procedure. In some
instances, this adjunct tissue removal can result in an increase in clitoral
sensation during normal sexual activity.

10. Is clitoral unhooding as
involved a procedure as labiaplasty? And should a woman consider having
this procedure done?

Clitoral unhooding (also known as Hoodectomy) is analogous
to circumcision in men. It involves reducing the tissue that forms a hood
or covering that shields the clitoris. Some surgeons won’t perform
this delicate operation because of the innervation (neuron cell density)
of the clitoral node is many times more concentrated than in any of the
surrounding tissue areas—thus if not done correctly, clitoral unhooding
can result in heightened sensation of the node by normal movements, in
some cases creating considerable discomfort. However, for surgeons who
perform the procedure regularly, clitoral unhooding can result in increased
stimulus of the clitoral node and many patients have reported increased
sexual climaxes (orgasms). Surgeons who do clitoral unhooding usually
have a method of determining the extent of sensitivity of the clitoris
before proceeding by testing the area with cold and warm swabs. Patients
SHOULD ONLY have this procedure performed by a surgeon who has extensive
experience in this area and has performed many clitoral unhoodings.

11. I have a 15-year-old daughter
with enlarged labia minora and it’s become an issue with her emotionally
as she gets older. She is asking about surgery to make her look more
normal. My gynecologist says that it can be done in his office. What is
the difference in having this procedure done in his office instead of
going to someone who specializes in this procedure?

Many young women and their parents don’t realize how
important it is to seek the surgical advice and experience of a physician
who has performed hundreds of labiaplasty procedures . . . until it is
too late. Simply loping off tissue, without regard to symmetry, or latent-tissue
retraction after healing, can result in disastrous results. Simply remember,
ONCE TISSUE IS REMOVED, IT RARELY CAN BE REPLACED . . . IF EVER. While
the family gynecologist is trained in gynecological anatomy and physiology;
procedures in labiaplasty or vaginoplasty are specialty areas not usually
taught during medical training. It is ALWAYS advisable to only proceed
with a surgeon skilled in performing numerous labiaplasty or vaginoplasty
procedures.

12. Can I have an asymmetrical
labia fixed to appear like the other side? If so, is the cost the same
as a total labiaplasty?

First, it’s important to understand that people develop
fairly anatomically symmetrical. This can be said for eyes, ears, limbs,
and of course, labia. So, when one side of the labia develops somewhat
asymmetrical (something that commonly occurs) it would be very hard to
match the irregular side, to the side that is preferred, because of differences
in color, labia thickness, and what is termed “rugation” (the
ruffled uneven edges of the labia) that occurs at the labia lip. As far
as a cost savings, it’s much more important to have a labiaplasty
procedure that results in asymmetrical labia, then save the small amount
of money and be unhappy with the end result. If cost is an issue, there
are a number of financing options available that we offer, which will
allow a good result without compromising patient satisfaction.

Absolutely not! If a women has enlarged, or asymmetrical
labia, it is the result of being born with them and it has nothing to
do with vibrators. More importantly, one must understand that a vibrator
is used for sexual stimulation of the clitoris—to aid in sexual
pleasure, while the labia have no means of providing pleasurable stimulation.
The labia minora are not involved in the process of sexual excitement.

14. I have read that after
labiaplasty a woman can experience lifelong sexual arousal problems.
Is this true?

No!! This is a common fallacy and it is completely wrong.
The media, which at times misinterprets accurate medical information,
commonly helps propagates this rumor as a means of creating controversy
or sensationalism. It is well known MEDICAL FACT that the labia have sensory
nerve fibers that ONLY transmit pain sensation, when stretched or torn.
There is NO SEXUAL STIMULATION ASSOCIATED WITH THE LABIA MINORA.

Free fat transfer, or FFT is indeed possible, and some surgeons
report success with this technique. Unfortunately, transplanted fat acts
in varying ways in different patients and it’s largely a matter
of technique to achieve good success. Because of this, there is a large
amount of evidence that in the majority of cases, fat can be reabsorbed
over a period of time and leave the area as it was before.

16. Is there a procedure to
make my clitoris larger or more exposed for greater sensitivity?

The size of the clitoral node (clitoris) cannot be increased
and is homologous (the same as the penis). Thus size is unrelated to increased
sensitivity.

However, sexual stimulation and arousal from the clitoris can be improved
if there is too much tissue covering the clitoral node. In these instances,
a clitoral unhooding or Hoodectomy, can remove excess tissue, and result
in more sensitivity. However, clitoral unhooding is a very delicate operation
and SHOULD ONLY be performed by a surgeon who first has a good method
of determining clitoral node sensitivity (usually a surgeon will develop
their own personal methods to do this) preoperatively; and has done numerous
procedures with a proven record of success.

Dissolvable sutures are used exclusively in labiaplasty.
Depending on the specific type of suture (there are a few different types),
and the location of the suture, they typically dissolve at 7 – 21
days (some dissolve in 7-10 days), allowing tissues to heal in the most
natural way.

18. A fatty mound of tissue
bulges out from my pubic region, giving me a more manly appearance in
underwear and form-fitting clothes. I’I'm told it’s my mons
pubis. Is there a way to liposuction this area?

As women age, this area, the Mons Pubis, tends to gain body
mass (fat). Liposuction is possible, but the results are often undesirable
and vary too greatly from patient to patient. Much of this is because
there is an excess amount of fatty tissue in the general area of the lower
abdomen, not just in the Mons Pubis region, and this can lead to additional
complications.

20. What types of pre-surgery
visits or consultations are necessary? Can they be done in one trip, or
will it require two or more?

Most women fly in the day before surgery. At that
time, a complete history is taken, including a physical; fluids are drawn
for lab analysis; and they’ll be a full review of consent forms
and other pre-surgery documents. Also at that time, digital photos will
be taken for use in a collaborative session to custom design the “look”
that the patient desires.

Typically, patients stay overnight in one of several hotels
with which we have working agreements. The surgery is scheduled
for the following morning.

Your surgeon will see you the next morning before you depart
on your return trip to make sure everything is as it should be. After
labiaplasty you can return to work or normal activity in about 3 - 4 days.
If you have both labiaplasty and vaginoplasty performed (combo surgery)
it’s usually recommended that you don’t return to normal activity
for at least 6 - 7 days. We recommend a 6-week postoperative visit,
but in many instances this isn't possible. In those instances (90 % of
patients are from out of state), a digital photo and follow up phone consult
is the norm. The patient shouldn't use Tampex, wear constricting undergarments
such as thongs, and refrain from sexual intercourse for at least 6 weeks
so the area can heal normally. As with any surgery, complete healing is
usually 3 months.

Typically a 72-hour notice to schedule surgery to come in
for the pre-surgical consult (see question above concerning visits and
pre op procedures). Or, patients may simply schedule their surgery in
advance, up to one month away.

“Normal” labia size is whatever you choose,
based on your own self-esteem. If you’re happy with your existing
labia, whether symmetrical, or asymmetrical, and you have no problems
with the way they look, then, in your case, “normal” labia
is whatever you choose, or accept. The point to remember is that with
labiaplasty, you can literally pick and choose the size or shape of your
labia, and elect to have they anatomically reformed, if you wish.

24. I would specifically like
to know if vaginoplasty and labiaplasty can be done at the same time—and
is there a cost savings?

Combination Labiaplasty (reduction & beautification)
& Vaginoplasty (rejuvenation & tightening) can be performed at
the same time, and the cost is markedly less than the single combined
price of having each done separately.

25. Can I send digital pictures
to do a phone consultation and then fly down for the preoperative consult
before surgery?

Because 90 % of patients come from out of state (often out
of the country), your surgeon will have extensive phone and e-mail consultations
with you prior to booking a procedure. Part of this process sometimes
involves the viewing of a patient’s photos prior to them coming
in for a face-to-face consult.

26. I have read that some surgeons
do labiaplasty surgery by laser while others use a scalpel. Which
is better?

Depending on the individual surgeon’s preference,
some use lasers and others use scalpels. Others use Iris Scissors for
labiaplasty (the same instrument typically used for eye surgery (Blepharoplasty),
and face-lifts (Rhytidectomy). While the laser is fine for long straight
incisions it doesn't leave the natural edge that an Iris Scissor does,
which makes the labia look normal when the surgery is finished. When working
on the labia, and making the correct incisions, in the right areas, there
is rarely any apparent visible scarring.

27. I've read about different
labiaplasty surgical methods such as laser versus Iris scissors. As I
understand it there are differences in the procedure and results. Can
you explain this to me?

What labiaplasty surgery is all about is creating or recreating
small, beautiful, comfortable labia minora. The bottom line is the
outcome . . . the destination, not the journey. First, if
a laser was so much better, than why isn't it used for other cosmetic
procedures such as facelifts, eyes, ears, breast augmentation, and most
other aesthetic procedures. The answer is simple; creating the most naturally
appearing end result comes with cosmetic iris scissors. Yes, lasers
make nice straight incisions. The problem is, there are few, if any straight
lines on the human body. There is no difference in recuperation time.
Back to work or school in 3 days. Your surgery generally looks good
at 4 weeks and you feel good at 6 weeks. In most cases, the reason
a laser is used for labiaplasty is because it’s far quicker a procedure,
and easier for the surgeon.